"Over the past few decades, cheerleading has evolved from
leading the crowd in cheers at sporting events to a competitive,
year-round activity featuring complex acrobatic stunts performed by
a growing number of athletes," said Dr. Cynthia LaBella, medical
director of the Institute for Sports Medicine at the Ann &
Robert Lurie Children's Hospital of Chicago. "As a result, the
number and severity of injuries from cheerleading has also
surged."

"Relatively speaking, the overall injury rate is low compared to
other girls' sports, such as soccer and basketball," LaBella said.
"But despite the lower overall injury rate, cheerleading accounts
for a disproportionate number -- 60 percent to 70 percent -- of all
the catastrophic injuries in girls' high school sports. That is an
area of concern and needs attention for improving safety."

LaBella, who is also an associate professor of pediatrics at the
Northwestern University Steinberg School of Medicine, was scheduled
to discuss the issue Thursday at the annual meeting of the National
Athletic Trainers' Association, in Las Vegas.

According to a policy statement issued by the American Academy
of Pediatrics (AAP) last fall, the number of students aged 6 and up
who engaged in cheerleading either at school or as members of
offsite competitive squads skyrocketed from just 600,000 students
in 1990 to somewhere between 3 million and 3.6 million in 2003.

The vast majority of participants -- 96 percent -- are girls,
according to the AAP, and what these girls are now asked to do goes
far beyond the stereotypical image of fun-loving dance routines.
Rather, girls must routinely execute taxing feats of gymnastic
prowess, with sequences that involve tumbling, leaping, jumping,
tossing and human-pyramid building.

What's more, "injury rates increase with age and skill level,
due to more complex stunts being performed at these levels,"
LaBella said.

The result has been a notable increase in the frequency with
which cheerleaders fall, sometimes from great heights. A range of
limb, head, neck and trunk injuries, as well as sprains and
strains, can ensue, with some -- such as concussions -- being
serious enough to require medical attention.

It is no longer unheard of to see cheerleading participants
leave the field of play having suffered permanently disabling or
even fatal catastrophic injuries.

"For those who have not seen cheerleading in 20 years, it really
would be an eye-opener," said Lisa Kluchorosky, a sports medicine
administrator at Nationwide Children's Hospital in Columbus, Ohio.
"So many [people] still think it's the world of Annette Funicello.
But cheerleading has gone from a more recreational, more supportive
kind of role to being very competitive and very athletic, which
means that the demands placed on these kids are really
enormous.

"And the skill level and the types of stunts they are doing have
gone up tremendously, as they have with most sports over the
years," Kluchorosky added.

With this new reality in mind, the AAP now takes the position
that state athletic associations should move to classify
cheerleading as a sport, in order to ensure that the activity is
treated in the same manner as all other traditional contact
athletics.

"Cheerleading is still not considered a sport in many states,
and it very much should be," said Kluchorosky, who is the National
Athletic Trainers' Association liaison to the AAP. "If it were
designated as such, it would be subject to the rules of all other
sports, which means participants would be afforded the same
resources and health care, and held to the same regulations."

For example, under a sports designation, cheerleaders would have
to engage in strength and conditioning programs during both
competition and preseason periods. Practice time would be
regulated, and training facilities certified as safe. Participants
also would have access to onsite medical staff when needed, all of
whom would be prepped with detailed emergency medical plans.

As part of a recognized sport, cheerleading coaches, in turn,
would have to be certified as to their proficiency in teaching key
cheerleading skills, such as spotting techniques.

Beyond that, the AAP further recommended placing specific
boundaries on the kinds of activities cheerleaders can be asked to
do, including limiting human pyramids to a certain height and
banning tumbling on hard surfaces that lack appropriate landing
matting.

"There's still some of the feeling out there that [cheerleading]
is not a real sport," Kluchorosky said. "But it is. And we're
talking about real risks, so we have to try to move the needle
forward and deal with it appropriately."

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.